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Bacitracin zinc + polymyxin b sulfate + hydrocortisone acetate + neomycin is a marketed **combination ophthalmic ointment** comprising three topical antibiotics and one corticosteroid. Neomycin is an aminoglycoside that inhibits bacterial protein synthesis by binding the bacterial 30S ribosomal subunit; polymyxin B disrupts susceptible Gram-negative bacterial cell membranes; bacitracin inhibits bacterial cell wall synthesis; and hydrocortisone acetate provides local anti-inflammatory corticosteroid activity through glucocorticoid receptor signaling. The product is indicated for steroid-responsive inflammatory ocular conditions in which bacterial infection is present or there is a risk of bacterial infection, including inflammatory conditions of the palpebral and bulbar conjunctiva, cornea, anterior segment of the globe, chronic anterior uveitis, and corneal injury from chemical, radiation, or thermal burns or foreign-body penetration. It is an approved and marketed pharmaceutical product in the United States and is available as branded and generic ophthalmic ointment products, including products associated with Bausch & Lomb.
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